Medical Records Coder

County of Contra Costa; Martinez (CA); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Excellent employee benefits

Job summary

County of Contra Costa seeks a Medical Records Coder for the Contra Costa Health Plan in Martinez, CA. The role focuses on accurate coding, auditing, validation, and adjudication of medical claims to ensure payment accuracy and regulatory compliance.

Candidates should be detail oriented, a strong communicator, and dependable, with AHIMA certifications or equivalent and experience in coding in a hospital or managed care setting.

Qualifications

• Minimum AHIMA or equivalent coding certification as described.
• Experience abstracting and coding medical data in hospital or managed care.
• Ability to analyze documentation and apply coding guidelines.
• Commitment to ongoing learning and staying current with changes.

Responsibilities

• Research coding guidelines, reimbursement methods, and auditing processes.
• Audit medical claims for coding accuracy and payment discrepancies.
• Identify Fraud, Waste, and Abuse through coding review.
• Review provider contract configurations, fee schedules, and coding changes.
• Collaborate with IT and operations to resolve coding and claims issues.
• Support audits with coding expertise and documentation guidance.

Skills

Detail oriented

Strong communicator

Team player

Dependable

Education

AHIMA CCS/CCS-P or AHIMA CCA/CPC-A/CPC-H-A/CPC-P-A/CIC

AHIMA CPC/COC/CPC-P

RHIA/RHIT/CTR (NCRA) + six months experience

Job description

Why Join Contra Costa County?

The Contra Costa Health Department is offering an excellent career opportunity for qualified individuals interested in the Medical Records Coder position. There is currently one (1) vacancy in the Contra Costa Health Plan (CCHP) Claims Unit in Martinez, CA.

CCHP is a federally qualified, state-licensed, and county-sponsored Health Maintenance Organization (HMO) serving Contra Costa County in the East Bay of the San Francisco Bay Area. Established in 1973, CCHP was the first county-sponsored HMO in the United States and today serves as the largest managed care health plan in Contra Costa County, covering more than 250,000 residents. CCHP is committed to providing equitable, accessible, and high-quality healthcare to our culturally and linguistically diverse members.

The Medical Records Coder is responsible for ensuring accurate coding, auditing, validation, and adjudication of medical claims. This position plays a critical role in maintaining claims payment accuracy, supporting system integrity, and ensuring compliance with state and federal regulations.

We are looking for someone who is:

• Detail Oriented. You will be responsible for accurately coding and abstracting sensitive information
• A strong communicator. You must communicate effectively verbally and in writing
• A team player. You will be expected to work both independently and as part of a team
• Dependable. You will be responsible for day-to-day assignments, staying updated about all regulation changes, and participating in on-going training

What you will typically be responsible for at CCHP:

• Researching coding issues, guidelines, and reimbursement methodologies
• Auditing medical claims for coding accuracy and payment discrepancies
• Identifying potential Fraud, Waste, and Abuse (FWA), including inappropriate coding
• Reviewing and validating provider contract configurations, reimbursement methodologies, fee schedule updates and coding changes
• Collaborating with IT and operational teams to resolve coding, reimbursement, and claims processing issues
• Supporting internal and external audits by providing coding expertise, documentation, and guidance

A few reasons you might love this job:

• You will be a part of a strong and supportive leadership team
• You will have room to grow with possible advancement opportunities
• Your work will directly benefit revenue to allow more services and programs for our community
• Excellent employee benefits and retirement!

A few challenges you might face in this job:

• Constant changes in rules and regulations may be challenging
• Approval processes may slow down the workflow
• Problem-solving issues may be complex and involve multiple stakeholders

Competencies Required:

• Critical Thinking:Analytically and logically evaluating information, propositions, and claims
• Delivering Results:Meeting organizational goals and customer expectations and making decisions that produce high-quality results by applying technical knowledge, analyzing problems, and calculating risks
• Reading Comprehension:Understanding and using written information
• Using Technology:Working with electronic hardware and software applications
• Adaptability:Responding positively to change and modifying behavior as the situation requires
• Attention to Detail:Focusing on the details of work content, work steps, and final work products
• Displaying Ownership and Accountability:Holding self and others accountable for measurable high-quality, timely, and cost-effective results
• Handling Stress:Maintaining emotional stability and self-control under pressure, challenge, or adversity
• Professional Integrity & Ethics:Displaying honesty, adherence to principles, and personal accountability
• Self-Management:Showing personal organization, self-discipline, and dependability
• Oral Communication:Engaging effectively in dialogue
• Customer Focus:Attending to the needs and expectations of customers
• Interpersonal Savvy:Considering and responding appropriately to the needs and feelings of others in different situations

To read the complete job description, please visit the website: https://www.cccounty.us/hr

The eligible list established from this recruitment may remain in effect for six (6) months.

Certification Required:

Possess and maintain a valid Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician based (CCS-P) certification issued by the American Health Information Management Association (AHIMA).

OR

Possess and maintain a valid Certified Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA) or Certified Professional Coder-Associate (CPC-A), or Certified Professional Coder-Hospital- Associate (CPC-H-A) or Certified Professional Coder-Payer- Associate (CPC-P-A), or Certified Inpatient Coder (CIC) certification issued by the American Academy of Professional Coders.

OR

Possess and maintain a valid certification: Certified Professional Coder (CPC), or Certified Outpatient Coder-Hospital (COC), or Certified Professional Coder-Payer (CPC-P) issued by the American Academy of Professional Coders.

OR

Possess and maintain a valid Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Tumor Registrar (CTR) Certification issued by the National Cancer Registrars Association (NCRA) AND six (6) months of experience (or its equivalent) abstracting and coding medical data in a hospital setting, medical office, outpatient clinic or managed care organization (i.e., HMO).

Applicants are required to attach a copy of their certification(s) to their application.

Desirable Qualifications:

• Experience with medical claims, reimbursement, and payment methodologies.
• Experience identifying Fraud, Waste, and Abuse (FWA) through coding review, documentation analysis, and claims auditing.
• Ability to analyze documentation, resolve coding discrepancies, and apply coding guidelines.
• Commitment to ongoing learning and staying current with coding, reimbursement, and healthcare regulatory changes.

1. Application Filing and Evaluation: All applicants will be required to complete a supplemental questionnaire at the time of application. Applications will be evaluated to determine which candidates will move forward in the next phase of the recruitment process.
2. Training and Experience Evaluation: At the time of filing, candidates will be required to complete a supplemental questionnaire, which will be used for the training and experience evaluation. Candidates that clearly meet the minimum qualifications, as described above, will have their training and experience responses evaluated. The questionnaire is designed to measure candidate’s relevant education, training, and/or experience as it relates to the Medical Records Coder classification. (Weighted 100%).

The Human Resources Department may change the examination steps noted above in accordance with the Personnel Management Regulations and accepted selection practices.

For recruitment questions, please contact Health Services Personnel, Recruitment Team at [e-mail]. For any technical issues, please contact the GovernmentJobs’ applicant support team for assistance at [phone].

CONVICTION HISTORY

After you receive a conditional job offer, you will be fingerprinted, and your fingerprints will be sent to the California Department of Justice (DOJ) and the Federal Bureau of Investigation (FBI). The resulting report of your conviction history (if any) will be used to determine whether the nature of your conviction conflicts with the specific duties and responsibilities of the job for which you have received a conditional job offer. If a conflict exists, you will be asked to present any evidence of rehabilitation that may mitigate the conflict, except when federal or state regulations bar employment in specific circumstances. Having a conviction history does not automatically preclude you from a job with Contra Costa County. If you accept a conditional job offer, the Human Resources department will contact you to schedule a fingerprinting appointment.

DISASTER SERVICE WORKER

All Contra Costa County employees are designated Disaster Service Workers through state and local law. Employment with the County requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker-related training as assigned, and to return to work as ordered in the event of an emergency.

EQUAL EMPLOYMENT OPPORTUNITY

It is the policy of Contra Costa County to consider all applicants for employment without regard to race, color, religion, sex, national origin, ethnicity, age, disability, sexual orientation, gender, gender identity, gender expression, marital status, ancestry, medical condition, genetic information, military or veteran status, or other protected category under the law.

Contra Costa County is committed to providing equal access and opportunity to qualified individuals with disabilities in its employment practices. If you believe you may anticipate needing reasonable accommodation, please visit our job seeker resources page at: Special Testing Accommodations | Contra Costa County, CA Official Website.